Provider Demographics
NPI:1710957683
Name:RISING GROUND. INC
Entity Type:Organization
Organization Name:RISING GROUND. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DREISLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-375-8700
Mailing Address - Street 1:463 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705
Mailing Address - Country:US
Mailing Address - Phone:914-375-8719
Mailing Address - Fax:914-375-8902
Practice Address - Street 1:463 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705
Practice Address - Country:US
Practice Address - Phone:914-375-8719
Practice Address - Fax:914-375-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02495141Medicaid
NY00328074Medicaid